FMGE 2017 — Psychiatry
6 Previous Year Questions with Answers & Explanations
A 6 year old child who does not interact with other children of his age group and prefers playing alone with repetitive behaviors, is likely to be suffering from:
Prosopagnosia is:
Drug of choice for treatment of akathisia is:-
A nondiabetic, nonhypertensive patient has occasional extra heartbeats. The doctor informed them it is benign, but the patient continues to seek investigations from doctor to doctor. This is a type of:
Which of the following terms describes sexual attraction or relationships primarily between women?
Indoor management of anorexia nervosa is done on priority patients with:-
FMGE 2017 - Psychiatry FMGE Practice Questions and MCQs
Question 1: A 6 year old child who does not interact with other children of his age group and prefers playing alone with repetitive behaviors, is likely to be suffering from:
- A. ADHD
- B. Autism (Correct Answer)
- C. Depression
- D. Bipolar disorder
Explanation: ***Autism*** - Difficulties in **social interaction** and **communication**, along with **repetitive behaviors** and restricted interests, are core diagnostic features of **Autism Spectrum Disorder (ASD)**. - The child's preference for playing alone and lack of interaction with peers are hallmark signs of **social deficits** in ASD. *ADHD* - **Attention-Deficit/Hyperactivity Disorder (ADHD)** primarily involves difficulties with **inattention**, **hyperactivity**, and **impulsivity**. - While children with ADHD may struggle socially, repetitive behaviors and a complete lack of interest in peer interaction are not typical primary symptoms. *Depression* - **Depression** in children often presents with **sadness**, **loss of interest** in previously enjoyed activities, changes in sleep or appetite, and irritability. - Social withdrawal in depression is usually due to low mood or anhedonia, rather than a fundamental difficulty in social understanding or a preference for repetitive play. *Bipolar disorder* - **Bipolar disorder** in children involves distinct episodes of **mania** (elevated mood, increased energy, decreased need for sleep) and **depression**. - The symptoms described do not align with the characteristic mood swings and episodic nature of bipolar disorder.
Question 2: Prosopagnosia is:
- A. Inability to recognize face (Correct Answer)
- B. Inability to read
- C. Anosmia
- D. Inability to write
Explanation: ***Inability to recognize face*** - **Prosopagnosia**, or **face blindness**, is a cognitive disorder characterized by an impaired ability to recognize familiar faces, including one's own. - This condition is often associated with damage to the **fusiform face area** in the brain, typically in the right hemisphere. *Inability to read* - The inability to read is known as **alexia** or **dyslexia**, which is distinct from the visual recognition deficit seen in prosopagnosia. - Alexia primarily involves difficulties with processing written language, not the visual recognition of faces. *Anosmia* - **Anosmia** refers to the complete or partial loss of the sense of smell and is a disorder affecting the olfactory system. - It is unrelated to visual processing or face recognition. *Inability to write* - The inability to write is termed **agraphia** or **dysgraphia**, a neurological condition that impairs writing ability. - This condition affects motor skills and language processing related to writing, not visual face recognition.
Question 3: Drug of choice for treatment of akathisia is:-
- A. Haloperidol
- B. Fluoxetine
- C. Propranolol (Correct Answer)
- D. Lithium
Explanation: ***Propranolol*** - **Beta-blockers** like propranolol are considered first-line for treating **akathisia**, especially in cases induced by antipsychotics. - They work by reducing the **adrenergic hyperactivity** and the sensation of inner restlessness characteristic of akathisia. *Haloperidol* - Haloperidol is a **first-generation antipsychotic** that is a common cause of drug-induced **akathisia**. - Administering it would likely **worsen** rather than treat the condition. *Fluoxetine* - Fluoxetine is a **selective serotonin reuptake inhibitor (SSRI)** used to treat depression and anxiety disorders. - It is not indicated for the treatment of **akathisia** and can sometimes induce or worsen motor restlessness. *Lithium* - Lithium is a **mood stabilizer** primarily used for bipolar disorder. - It is not a treatment for **akathisia** and can itself cause various neurological side effects, though akathisia is less common.
Question 4: A nondiabetic, nonhypertensive patient has occasional extra heartbeats. The doctor informed them it is benign, but the patient continues to seek investigations from doctor to doctor. This is a type of:
- A. Depression
- B. Conversion disorder
- C. Somatoform pain
- D. Illness Anxiety Disorder (Correct Answer)
Explanation: ***Illness Anxiety Disorder*** - This condition is characterized by **preoccupation with having or acquiring a serious illness**, despite minimal or no somatic symptoms, or an excessive preoccupation if symptoms are present. - The patient's repeated seeking of investigations despite medical assurance of a benign condition aligns with the diagnostic criteria of **illness anxiety disorder**, where reassurance has little effect. *Depression* - While **depressive symptoms** (e.g., low mood, anhedonia) can coexist with health anxieties, the primary driver here is the fear of serious illness rather than pervasive sadness or loss of interest. - Patients with depression typically report a **generalized dysphoria** or lack of energy, which is not the central issue described. *Conversion disorder* - Involves **neurological symptoms** (e.g., paralysis, blindness, seizures) that are incompatible with recognized neurological conditions and are not intentionally produced. - The patient's concern is about a benign cardiac finding, not the sudden onset of **functional neurological deficits**. *Somatoform pain* - This term is older and has largely been replaced by **Somatic Symptom Disorder with predominant pain**, where psychological factors play a significant role in the onset, severity, exacerbation, or maintenance of pain. - The patient's main concern is about the **implication of a benign symptom** rather than experiencing overwhelming pain itself.
Question 5: Which of the following terms describes sexual attraction or relationships primarily between women?
- A. Masochism
- B. Nymphomania
- C. Transsexualism
- D. Lesbianism (Correct Answer)
Explanation: ***Lesbianism*** - **Lesbianism** describes sexual attraction or relationships primarily between **women**. - It is a form of **homosexuality**, specifically referring to female same-sex attraction. *Masochism* - **Masochism** is a paraphilia where sexual gratification is derived from experiencing **pain, humiliation, or bondage**. - This term does not describe the gender of individuals involved in a sexual relationship. *Nymphomania* - **Nymphomania** is an outdated and stigmatizing term historically used to describe a woman with an **uncontrollably strong desire for sexual activity**. - It does not refer to the gender of the individuals involved in the sexual attraction. *Transsexualism* - **Transsexualism** refers to the condition of a **transgender person** who identifies with a sex different from their birth sex and often seeks to transition through medical interventions. - This term describes **gender identity** rather than sexual orientation or the gender composition of a relationship.
Question 6: Indoor management of anorexia nervosa is done on priority patients with:-
- A. Depression
- B. Amenorrhea
- C. Binging episodes
- D. Weight for height less than 75% of normal (Correct Answer)
Explanation: ***Weight for height less than 75% of normal*** - A **weight for height less than 75% of normal** (or **BMI <15 kg/m²**) indicates severe **malnutrition** and a high risk of medical complications, necessitating urgent inpatient care. - This level of **underweight** is a critical indicator for hospital admission in **anorexia nervosa** to prevent severe organ dysfunction, refeeding syndrome, and even death. *Depression* - While **depression** is a common comorbidity with **anorexia nervosa** and often requires treatment, it does not, by itself, warrant immediate inpatient management unless there are acute **suicidal risks**. - **Depression** is usually managed in an outpatient setting initially, with hospitalization being reserved for severe cases where safety is compromised. *Amenorrhea* - **Amenorrhea** (absence of menstruation) is a common symptom of **anorexia nervosa** due to hormonal imbalances caused by low body weight. - Though an indicator of significant caloric restriction, **amenorrhea** alone is not typically an immediate criterion for inpatient admission unless accompanied by other severe physical complications. *Binging episodes* - While **binging episodes** can occur in **anorexia nervosa** (specifically the binge-purging subtype) and can lead to electrolyte imbalances or medical complications, they are not the primary, stand-alone trigger for immediate inpatient admission. - The severity of **binging** and associated **purging behaviors** must be evaluated in the context of overall medical stability and weight to determine the appropriate level of care.